A process for developing a sustainable and scalable approach to community engagement: community dialogue approach for addressing the drivers of antibiotic resistance in Bangladesh
Abstract Background Community engagement approaches that have impacted on health outcomes are often time intensive, small-scale and require high levels of financial and human resources. They can be difficult to sustain and scale-up in low resource settings. Given the reach of health services into co...
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| Format: | Article |
| Language: | English |
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BMC
2020-06-01
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| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12889-020-09033-5 |
| _version_ | 1818064266527244288 |
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| author | Rebecca King Joseph Hicks Christian Rassi Muhammad Shafique Deepa Barua Prashanta Bhowmik Mahua Das Helen Elsey Kate Questa Fariza Fieroze Prudence Hamade Sameena Huque James Newell Rumana Huque |
| author_facet | Rebecca King Joseph Hicks Christian Rassi Muhammad Shafique Deepa Barua Prashanta Bhowmik Mahua Das Helen Elsey Kate Questa Fariza Fieroze Prudence Hamade Sameena Huque James Newell Rumana Huque |
| author_sort | Rebecca King |
| collection | DOAJ |
| description | Abstract Background Community engagement approaches that have impacted on health outcomes are often time intensive, small-scale and require high levels of financial and human resources. They can be difficult to sustain and scale-up in low resource settings. Given the reach of health services into communities in low income countries, the health system provides a valuable and potentially sustainable entry point that would allow for scale-up of community engagement interventions. This study explores the process of developing an embedded approach to community engagement taking the global challenge of antibiotic resistance as an example. Methods The intervention was developed using a sequential mixed methods study design. This consisted of: exploring the evidence base through an umbrella review, and identifying key international standards on the appropriate use of antibiotics; undertaking detailed formative research through a) a qualitative study to explore the most appropriate mechanisms through which to embed the intervention within the existing health system and community infrastructure, and to understand patterns of knowledge, attitudes and practice regarding antibiotics and antibiotic resistance; and b) a household survey – which drew on the qualitative findings - to quantify knowledge, and reported attitudes and practice regarding antibiotics and antibiotic resistance within the target population; and c) drawing on appropriate theories regarding change mechanisms and experience of implementing community engagement interventions to co-produce the intervention processes and materials with key stakeholders at policy, health system and community level. Results A community engagement intervention was co-produced and was explicitly designed to link into existing health system and community structures and be appropriate for the cultural context, and therefore have the potential to be implemented at scale. We anticipate that taking this approach increases local ownership, as well as the likelihood that the intervention will be sustainable and scalable. Conclusions This study demonstrates the value of ensuring that a range of stakeholders co-produce the intervention, and ensuring that the intervention is designed to be appropriate for the health system, community and cultural context. |
| first_indexed | 2024-12-10T14:33:16Z |
| format | Article |
| id | doaj.art-3d510e8433f44451839016452a66f2cd |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-12-10T14:33:16Z |
| publishDate | 2020-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-3d510e8433f44451839016452a66f2cd2022-12-22T01:44:54ZengBMCBMC Public Health1471-24582020-06-0120111310.1186/s12889-020-09033-5A process for developing a sustainable and scalable approach to community engagement: community dialogue approach for addressing the drivers of antibiotic resistance in BangladeshRebecca King0Joseph Hicks1Christian Rassi2Muhammad Shafique3Deepa Barua4Prashanta Bhowmik5Mahua Das6Helen Elsey7Kate Questa8Fariza Fieroze9Prudence Hamade10Sameena Huque11James Newell12Rumana Huque13Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, University of LeedsNuffield Centre for International Health and Development, Leeds Institute of Health Sciences, University of LeedsMalaria Consortium, The Green HouseMalaria Consortium, The Green HouseARK Foundation, Suite C-3 &C-4ARK Foundation, Suite C-3 &C-4Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, University of LeedsCentre for Health and Population Sciences, Hull York Medical School, University of YorkNuffield Centre for International Health and Development, Leeds Institute of Health Sciences, University of LeedsARK Foundation, Suite C-3 &C-4Malaria Consortium, The Green HouseARK Foundation, Suite C-3 &C-4Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, University of LeedsARK Foundation, Suite C-3 &C-4Abstract Background Community engagement approaches that have impacted on health outcomes are often time intensive, small-scale and require high levels of financial and human resources. They can be difficult to sustain and scale-up in low resource settings. Given the reach of health services into communities in low income countries, the health system provides a valuable and potentially sustainable entry point that would allow for scale-up of community engagement interventions. This study explores the process of developing an embedded approach to community engagement taking the global challenge of antibiotic resistance as an example. Methods The intervention was developed using a sequential mixed methods study design. This consisted of: exploring the evidence base through an umbrella review, and identifying key international standards on the appropriate use of antibiotics; undertaking detailed formative research through a) a qualitative study to explore the most appropriate mechanisms through which to embed the intervention within the existing health system and community infrastructure, and to understand patterns of knowledge, attitudes and practice regarding antibiotics and antibiotic resistance; and b) a household survey – which drew on the qualitative findings - to quantify knowledge, and reported attitudes and practice regarding antibiotics and antibiotic resistance within the target population; and c) drawing on appropriate theories regarding change mechanisms and experience of implementing community engagement interventions to co-produce the intervention processes and materials with key stakeholders at policy, health system and community level. Results A community engagement intervention was co-produced and was explicitly designed to link into existing health system and community structures and be appropriate for the cultural context, and therefore have the potential to be implemented at scale. We anticipate that taking this approach increases local ownership, as well as the likelihood that the intervention will be sustainable and scalable. Conclusions This study demonstrates the value of ensuring that a range of stakeholders co-produce the intervention, and ensuring that the intervention is designed to be appropriate for the health system, community and cultural context.http://link.springer.com/article/10.1186/s12889-020-09033-5Community engagementAntibiotic resistanceAntimicrobial resistanceIntervention developmentBangladesh |
| spellingShingle | Rebecca King Joseph Hicks Christian Rassi Muhammad Shafique Deepa Barua Prashanta Bhowmik Mahua Das Helen Elsey Kate Questa Fariza Fieroze Prudence Hamade Sameena Huque James Newell Rumana Huque A process for developing a sustainable and scalable approach to community engagement: community dialogue approach for addressing the drivers of antibiotic resistance in Bangladesh BMC Public Health Community engagement Antibiotic resistance Antimicrobial resistance Intervention development Bangladesh |
| title | A process for developing a sustainable and scalable approach to community engagement: community dialogue approach for addressing the drivers of antibiotic resistance in Bangladesh |
| title_full | A process for developing a sustainable and scalable approach to community engagement: community dialogue approach for addressing the drivers of antibiotic resistance in Bangladesh |
| title_fullStr | A process for developing a sustainable and scalable approach to community engagement: community dialogue approach for addressing the drivers of antibiotic resistance in Bangladesh |
| title_full_unstemmed | A process for developing a sustainable and scalable approach to community engagement: community dialogue approach for addressing the drivers of antibiotic resistance in Bangladesh |
| title_short | A process for developing a sustainable and scalable approach to community engagement: community dialogue approach for addressing the drivers of antibiotic resistance in Bangladesh |
| title_sort | process for developing a sustainable and scalable approach to community engagement community dialogue approach for addressing the drivers of antibiotic resistance in bangladesh |
| topic | Community engagement Antibiotic resistance Antimicrobial resistance Intervention development Bangladesh |
| url | http://link.springer.com/article/10.1186/s12889-020-09033-5 |
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